NASHVILLE - Republican Gov. Bill Haslam is expected to announce his decision today regarding an expansion of the state's Medicaid program, TennCare, under the federal health care law, according state Capitol sources.
Haslam spokesman David Smith declined to answer questions late Tuesday afternoon, other than to say, "All I can do is encourage you to be in the House Chamber tomorrow morning or watch it online."
Legislative officials are planning a joint convention of the Republican-controlled General Assembly.
Ever since a U.S. Supreme Court ruling in June that left the decision to states, Haslam has been struggling with whether to extend TennCare to an estimated 181,000 low-income Tennesseans. The state would see $1.4 billion in additional federal Medicaid funding in the first year.
The move is opposed by any number of majority GOP lawmakers, who warn the federal funding is sketchy given the federal debt, as well as the party's base. On the other side of the equation, hospitals, many local Chambers of Commerce and others are pushing for expansion.
The hospital industry says some hospitals could go broke without expansion.
On Monday, Haslam told reporters he would finally make a decision this week after Republican Senate Speaker Ron Ramsey said time was running out. Two Williamson County Republican lawmakers are expected to press bills in committee today banning the expansion.
"We literally still are in the middle of a lot of last-minute discussions with a lot of people," Haslam said. "This is an incredibly complex issue. Every day I'm learning something new about the law, its impact on Tennessee, about its impact on local governments, on its impact on business."
He said "it's prudent to make certain that we know as much as we can before we come to that decision." Still, he acknowledged the "politics are difficult" with fellow Republicans who are opposed.
Some fellow Republicans think the governor will announce today he won't pursue expansion this year but delay a final decision in order to work with the Obama administration toward a deal that gives the state more flexibility.
Asked whether he might opt to put the issue off a year, Haslam said earlier this week, "well, I guess that's always a piece of the decision."
"I think what we're working hard to try to say what's the right decision for now, legally, because the U.S. Supreme Court says you don't have to expand. It means you don't have to decide now or a year from now," he added.
But he said "we've been working toward the understanding that if we can come to a decision about what's best for Tennessee, to decide that now would be better than waiting."
Haslam said the state has been having conversations with Arkansas and Ohio officials as well as U.S. Health and Human Services officials.
Democratic Gov. Mike Beebe of Arkansas and Republican Gov. John Kaisich of Ohio are working on deals with HHS officials.
Under President Barack Obama's Affordable Care Act, the Medicaid expansion would be funded entirely during its first three years by the federal government. It would cover people whose incomes are up to 138 percent of the federal poverty level. That's an income of $15,870 for an individual or $32,499 for a family of four.
After that, the federal share gradually declines to 90 percent with states picking up the rest of the tab.
Beebe and Kaisich are trying to figure out a way in which they could use the federal expansion money to help would-be Medicaid recipients enroll in the health insurance exchanges also provided for in the law.
The online marketplaces provide people with incomes ranging from 100 percent to 400 percent of the federal poverty level with subsidized private insurance. The governors' idea is to use the Medicaid money to help the expansion population join the exchanges.